Big baby at birth causes,problems and management Custom Search
A big baby at birth is one whose weight is more than the 90th percentile. The normal weight at birth varies widely depending on maternal build, racial and genetic factors. However if the weight is more than the 90th percentile it is necessary to observe the baby closely for one or two days as such a baby is prone to develop some complications. Normal delivery may be difficult unless the mother’s pelvis is adequate for the passage of the fetus and caesarean section may be required. Birth injuries are more common. Causes of a big newborn baby and management Genetic: Mothers with heavy build are more likely to give birth to large babies but there seems to be no relation between father’s weight and baby’s weight. Maternal diabetes: Hyperglycemia in the mother (increased levels of blood glucose) causes hyperglycemia in the fetus, as glucose crosses the placenta. The fetal hyperglycemia causes the beta cells of pancreas (cells responsible for producing Insulin, the hormone which controls the level of sugar in blood) to produce more insulin. Insulin also brings about increase in body weight. Hence an infant of diabetic mother will be a big baby at birth.
After birth the high level of insulin persists for some time in the baby and this can result in hypoglycemia (low blood sugar). Hence, such babies need to be monitored for some time, with blood glucose estimation at frequent intervals. They may require intravenous glucose if the level of glucose in the blood is low. Hypoglycemia can be dangerous because it can cause convulsions and brain damage. These babies are also prone to suffer from polycythemia, a condition in which the blood is very thick and can clot inside the blood vessels. If it is severe the baby may require exchange transfusion with plasma or saline. Congenital hypothyroidism: Deficiency of thyroid hormones in the baby causes increased body weight. These babies also have constipation, hoarse cry, diminished activity and dry skin. If there in any doubt blood has to be sent for testing the level of thyroid hormone and treatment started early if it is low. Delay in treatment can cause mental retardation. Wiedemann-Beckwith syndrome: The baby will have grooves in ear lobes and large tongue. Some also have cleft palate and hypospadias (abnormal opening of the urethra). Chromosomal abnormalities have been demonstrated in some of these babies. They are also prone to develop hypoglycemia. Some also suffer from mental retardation. Transposition of great vessels: This is a congenital defect of the heart. In this the blood vessels arising from the heart (aorta and pulmonary artery) are connected to the wrong chambers of the heart. The beta cells of the pancreas receive blood containing more glucose and oxygen and hence produce more insulin resulting in increased growth of the body and a big baby at birth. They also require frequent monitoring of blood glucose after birth and intravenous glucose apart from treatment of the heart problem. Custom Search
Page last reviewed on 14th November 2009
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